# Parameter-efficient Prompt Tuning and Hierarchical Textual Guidance for Few-shot Whole Slide Image Classification

arXiv: https://arxiv.org/abs/2603.21504 · HTML: https://mlsanity.com/paper/2603.21504/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 28 of its 38 references that are in the map.
- First posted on arXiv 23 Mar 2026.

## Builds on (most cited first, 28 of 28)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [Scaling Up Visual and Vision-Language Representation Learning With Noisy Text Supervision](https://mlsanity.com/paper/2102.05918/) (2021)
- [Learning to Prompt for Vision-Language Models](https://mlsanity.com/paper/2109.01134/) (2021)
- [Attention-based Deep Multiple Instance Learning](https://mlsanity.com/paper/1802.04712/) (2018)
- [Vision-Language Models for Vision Tasks: A Survey](https://mlsanity.com/paper/2304.00685/) (2023)
- [Data Efficient and Weakly Supervised Computational Pathology on Whole Slide Images](https://mlsanity.com/paper/2004.09666/) (2020)
- [FILIP: Fine-grained Interactive Language-Image Pre-Training](https://mlsanity.com/paper/2111.07783/) (2021)
- [TransMIL: Transformer based Correlated Multiple Instance Learning for Whole Slide Image Classification](https://mlsanity.com/paper/2106.00908/) (2021)
- [Dual-stream Multiple Instance Learning Network for Whole Slide Image Classification with Self-supervised Contrastive Learning](https://mlsanity.com/paper/2011.08939/) (2020)
- [Scaling Vision Transformers to Gigapixel Images via Hierarchical Self-Supervised Learning](https://mlsanity.com/paper/2206.02647/) (2022)
- [Scaling & Shifting Your Features: A New Baseline for Efficient Model Tuning](https://mlsanity.com/paper/2210.08823/) (2022)
- [DTFD-MIL: Double-Tier Feature Distillation Multiple Instance Learning for Histopathology Whole Slide Image Classification](https://mlsanity.com/paper/2203.12081/) (2022)
- [Quilt-1M: One Million Image-Text Pairs for Histopathology](https://mlsanity.com/paper/2306.11207/) (2023)
- [Deep neural network models for computational histopathology: A survey](https://mlsanity.com/paper/1912.12378/) (2019)
- [Visual Language Pretrained Multiple Instance Zero-Shot Transfer for Histopathology Images](https://mlsanity.com/paper/2306.07831/) (2023)
- [Benchmarking foundation models as feature extractors for weakly-supervised computational pathology](https://mlsanity.com/paper/2408.15823/) (2024)
- [The Rise of AI Language Pathologists: Exploring Two-level Prompt Learning for Few-shot Weakly-supervised Whole Slide Image Classification](https://mlsanity.com/paper/2305.17891/) (2023)
- [Computational Pathology: A Survey Review and The Way Forward](https://mlsanity.com/paper/2304.05482/) (2023)
- [ViLa-MIL: Dual-scale Vision-Language Multiple Instance Learning for Whole Slide Image Classification](https://mlsanity.com/paper/2502.08391/) (2025)
- [FOCUS: Knowledge-enhanced Adaptive Visual Compression for Few-shot Whole Slide Image Classification](https://mlsanity.com/paper/2411.14743/) (2024)
- [Towards better understanding and better generalization of few-shot classification in histology images with contrastive learning](https://mlsanity.com/paper/2202.09059/) (2022)
- [Label-Efficient Deep Learning in Medical Image Analysis: Challenges and Future Directions](https://mlsanity.com/paper/2303.12484/) (2023)
- [MSCPT: Few-shot Whole Slide Image Classification with Multi-scale and Context-focused Prompt Tuning](https://mlsanity.com/paper/2408.11505/) (2024)
- [CAMIL: Context-Aware Multiple Instance Learning for Cancer Detection and Subtyping in Whole Slide Images](https://mlsanity.com/paper/2305.05314/) (2023)
- [Pathology-knowledge Enhanced Multi-instance Prompt Learning for Few-shot Whole Slide Image Classification](https://mlsanity.com/paper/2407.10814/) (2024)
- [FAST: A Dual-tier Few-Shot Learning Paradigm for Whole Slide Image Classification](https://mlsanity.com/paper/2409.19720/) (2024)
- [Discriminative Sample-Guided and Parameter-Efficient Feature Space Adaptation for Cross-Domain Few-Shot Learning](https://mlsanity.com/paper/2403.04492/) (2024)
- [MAPLE: Multi-scale Attribute-enhanced Prompt Learning for Few-shot Whole Slide Image Classification](https://mlsanity.com/paper/2509.25863/) (2025)

## Abstract (arXiv)

Whole Slide Images (WSIs) are giga-pixel in scale and are typically partitioned into small instances in WSI classification pipelines for computational feasibility. However, obtaining extensive instance level annotations is costly, making few-shot weakly supervised WSI classification (FSWC) crucial for learning from limited slide-level labels. Recently, pre-trained vision-language models (VLMs) have been adopted in FSWC, yet they exhibit several limitations. Existing prompt tuning methods in FSWC substantially increase both the number of trainable parameters and inference overhead. Moreover, current methods discard instances with low alignment to text embeddings from VLMs, potentially leading to information loss. To address these challenges, we propose two key contributions. First, we introduce a new parameter efficient prompt tuning method by scaling and shifting features in text encoder, which significantly reduces the computational cost. Second, to leverage not only the pre-trained knowledge of VLMs, but also the inherent hierarchical structure of WSIs, we introduce a WSI representation learning approach with a soft hierarchical textual guidance strategy without utilizing hard instance filtering. Comprehensive evaluations on pathology datasets covering breast, lung, and ovarian cancer types demonstrate consistent improvements up-to 10.9%, 7.8%, and 13.8% respectively, over the state-of-the-art methods in FSWC. Our method reduces the number of trainable parameters by 18.1% on both breast and lung cancer datasets, and 5.8% on the ovarian cancer dataset, while also excelling at weakly-supervised tumor localization. Code at https://github.com/Jayanie/HIPSS.